Childhood refractory epilepsy and cannabis

In this article we will talk about childhood refractory epilepsy and cannabis. We will also look at what epilepsy is, as well as the different types of seizures that people with epilepsy experience.

Refractory epilepsy is perhaps one of the least known types of epilepsy, although its effects on children can be devastating. Many people have no idea about the consequences of epilepsy, which is why it is good to know more about it.

It must also be said that different studies have shown hope for the possibility of using cannabis to treat refractory epilepsy.

What is epilepsy? Epilepsy definition

Epilepsy is a neurological condition in which a person experiences two or more spontaneous seizures separated by more than 24 hours. This is known as a commissural crisis. A seizure, on the other hand, is an abnormally high level of electrical activity in the brain that can cause a variety of symptoms depending on the areas of the brain affected.

Seizures that occur for no obvious reason, such as alcohol withdrawal, heart difficulties, or hypoglycemia, are called “unprovoked seizures. It should be noted that seizures can be inherited, or be the result of brain injury, but the reason they happen is often unknown.

Many people use the terms “seizure disorder” and “epilepsy” interchangeably. Provoked” seizures, such as those caused by acute hypoglycemia, are not called epilepsy.

In this regard, it is important to clarify that there are two types of seizures: focal seizures (focal epilepsy), often referred to as partial seizures, and generalized seizures.

refractory epilepsy in children

Types of seizures (types of epilepsy)

As for seizures and their meaning, they are defined as a momentary abnormality in muscle tone or movements (stiffness, spasms, or flaccidity), behaviors, perceptions, or states of consciousness. They are caused by uncontrolled electrical activity between brain cells, also called neurons or nerve cells.

However, we must say that not all seizures are the same. A seizure may occur as a single event resulting from an acute cause, such as a medication. Therefore, when a person experiences recurrent seizures, he or she is diagnosed with epilepsy.

The following are the most common types of epilepsy:

Focal epilepsy

The onset of focal seizures is marked by an aberrant electrical discharge confined to a single tiny area of the brain. They are further divided into groups according to their origin in the brain and how they affect consciousness, receptivity and memory.

Changes in behavior, thoughts, or movements are all possible symptoms of focal epilepsy. In addition, focal seizures may spread throughout the brain, resulting in a tonic-clonic seizure, which is a generalized seizure with loss of consciousness.

Head injuries, strokes, infections, tumors and other factors. They can cause focal seizures. They can also be caused by some inherited diseases.

Temporal lobe seizures

To understand how childhood refractory epilepsy and cannabis are related, it is also important to know about this type of seizure. In this case, they are similar to focal seizures. On each side of the skull, below the temples, is the temporal lobe, which is responsible for memory, emotions, interpretation of sounds, and understanding language.

The intensity of temporal lobe seizures varies. They can be so discreet that they often go unnoticed. For example, a person may experience unusual stomach pain or describe something as smelling “strange.

Also, during this type of seizure, people tend to make repetitive movements. Lip licking and hand rubbing are two examples of these behaviors.

Frontal lobe seizures (frontal epilepsy)

This is another type of epilepsy whose seizures occur in the frontal lobe, which is responsible for movement, decision-making, problem-solving, and emotions. Symptoms may include waking sleep, as well as jerking and twitching of the limbs. They usually occur at night, while the person is sleeping.

Parietal lobe seizures

Parietal lobe seizures account for only 5% of all seizures in patients with epilepsy. The parietal lobe is located in the center of the brain. This part of the brain is responsible for interpreting information related to touch, pain and space.

Occipital lobe seizures

The occipital lobe lies behind the parietal and temporal lobes in the brain. This is important because the brain’s visual system is located in the occipital lobe. There may be no known cause for this type of seizure, or an injury or injured area in the occipital lobe may be discovered.

An important thing to note is that occipital seizures have symptoms that are comparable to migraines, such as visual abnormalities, partial blindness, nausea, vomiting, and headache.

What is refractory epilepsy in children?

Epilepsy is a condition in which a person has experienced two or more seizures. Epilepsy is often controlled with medication. However, when a child’s seizures continue despite seizure medications, his or her epilepsy is known as refractory epilepsy.

Epileptic seizures in children occur all too frequently. As you might expect, epilepsy in infants is a condition that has serious implications due to the age of the infants.

In fact, refractory epilepsy, which affects 10-20% of children with epilepsy, has a significant impact on children’s education, social and cognitive functioning, and leisure activities.

causes refractory epilepsy in children

Causes of refractory epilepsy in children

Refractory epilepsy in children is caused by a variety of factors. However, without testing or surgery, it is often difficult for the doctor to establish the cause. Despite this, there are multiple variables that can contribute to refractory epilepsy becoming intractable:

  • Certain epilepsy syndromes
  • Experiencing more seizures during the first six months of life
  • The age at which seizures begin. (Children are at higher risk).
  • Having a developmental delay
  • History of prolonged seizures

It is also worth mentioning that refractory epilepsy in children can last a lifetime. As a result, children can experience many problems in the long run. For example:

  • They may have trouble doing their homework
  • They may also need help with daily tasks
  • Have an increased risk of injury
  • They may experience anxiety or depression
  • They may even have trouble sleeping and conceiving.
epilepsy diagnosis babies

How is epilepsy diagnosed in infants?

Your health care provider may recommend a variety of tests or procedures to look for the following, depending on your baby’s medical history and the results of the examination:

  • Structural abnormalities in the infant’s brain. Magnetic resonance imaging is used for this purpose.
  • Abnormal electrical activity in the brain using an electroencephalogram.
  • Metabolic problems or chemical disorders through a urine or blood test.
  • Genetic disorder through chromosomal testing.
  • Metabolic disorder or infections by lumbar puncture.

In any case, MRI is the best test to detect abnormalities in the structure of the brain. If a baby’s MRI looks normal during the first few months of life, the doctor will almost certainly repeat it later. This is because some abnormalities that were not obvious before, may appear around one year of age.

A lumbar puncture is a painless procedure used to obtain a sample of cerebrospinal fluid. In fact, the baby usually cries more when the doctor cleans the area with a cold antiseptic solution. In addition, the skin can be anesthetized with an anesthetic cream. Intravenous sedation is sometimes used to perform the test.

Childhood refractory epilepsy and cannabis

It is extremely important to diagnose and stop seizures in children with refractory epilepsy as early as possible. This is because its severity can increase over time and lead to developmental delays.

Many anti-seizure medications work by reducing the brain’s excitability. However, some people develop tolerance to these medications over time, rendering them ineffective. The precise reasons behind this are unknown. Mood swings, anger, visual impairment and fatigue are serious side effects.

In addition, these medications often need to be taken several times a day. This can make it difficult for children to follow a treatment plan because it disrupts their daily lives. However, there is hope for those whose medications have failed or who have refractory childhood epilepsy.

The ketogenic diet is becoming more popular as a treatment option. This is a rigorous, high-fat diet administered by a doctor as an alternative treatment for children with refractory epilepsy. However, researchers are not sure why the ketogenic diet prevents seizures.

It is thought that consuming a fat-to-carbohydrate ratio of 4:1 forces the body to burn ketones for energy instead of carbohydrates. While this diet is effective, food preparation is time-consuming and children may not follow it because they can’t eat many of their favorite snacks.

refractory infantile epilepsy treatment

Cannabis as a treatment for refractory epilepsy in children

As already mentioned, epilepsy long-term consequences can lead to a delay in child development. Therefore, it is important to find alternative treatments for childhood myoclonic epilepsy, and other types of epilepsy.

More genetic variants have been detected in children with epilepsy due to advances in genetic testing technologies. Doctors may choose anticonvulsant drugs that target specific mutations as a result. Genetic testing could possibly uncover previously unknown epilepsy mutations, paving the way for the development of a novel treatment.

Cannabis derivatives, such as CBD, have recently gained popularity as a therapy for refractory epilepsy in children. These CBD products are made from hemp and do not include any psychotropic ingredients. CBD has been found to reduce seizures in people with epilepsy. In fact, in the United States, the Food and Drug Administration authorized Epidiolex, a CBD medication for children with epilepsy.

CBD is supposed to stimulate inhibition of brain cell activity to reduce seizures, although the exact method of action is uncertain. In addition, this CBD epilepsy medicine has been shown to have fewer adverse effects than currently available anti-seizure medications.

It has also been used successfully in the treatment of two forms of refractory childhood epilepsy. A 2019 study revealed that H2CBD, a drug comparable to Epidiolex, has the same efficacy as CBD in reducing seizures. However, this study was done in rats, so more research is needed to determine if it would help children with refractory epilepsy.

It should be noted that even a small improvement is a big step, especially since it is very difficult to keep a child with refractory epilepsy stable. It should not be forgotten that tonic seizures and seizures depend on multiple factors, including emotional ones.

It should also be noted that many children do not have the ability to express themselves verbally. Therefore, they are unable to express what they feel, and cannot communicate adequately. Because of this, they become frustrated and may develop aggressive or self-injurious behavior.

Moreover, in most cases, parents of children with refractory epilepsy have already exhausted all known therapeutic treatments. Therefore, a CBD treatment for epilepsy represents a light at the end of the tunnel, considering its anticonvulsant effects and low toxicity.

cbd childhood refractory epilepsy

Expectations of CBD treatment for refractory epilepsy

The research considers that in 65% of patients with refractory epilepsy, it is possible to reduce the number of epileptic seizures in children, as well as their frequency of occurrence. Some children will experience a change in the type of seizure, decreasing in intensity.

As a result, children are calmer, and at the same time, their brains focus on performing the tasks and developing the skills required. In addition, it is important to note that many children with refractory epilepsy also have severe cognitive deficits.

This is relevant because a CBD treatment for refractory epilepsy also brings significant psychomotor and cognitive benefits. That is, children improve their school performance, relate better to their environment, and even interact actively.

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